| NPI | 1861675407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D76077) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 225530) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2014-05-08 |